Efficacy of percutaneous radiofrequency ablation may vary with clear cell renal cell cancer histologic subtype

2017 ◽  
Vol 43 (6) ◽  
pp. 1472-1477 ◽  
Author(s):  
Timothy McClure ◽  
Allan Pantuck ◽  
James Sayer ◽  
Steven Raman
Keyword(s):  
Radiofrequency Ablation ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Percutaneous Radiofrequency Ablation ◽  
Histologic Subtype

A phase II trial of everolimus and bevacizumab in advanced non-clear cell renal cell cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 411-411
Author(s):  
Martin Henner Voss ◽  
Yingbei Chen ◽  
Joshua Chaim ◽  
Devyn Taylor Coskey ◽  
Kaitlin Woo ◽  
...  
Keyword(s):  
Phase Ii ◽  
Renal Cell Cancer ◽  
Primary Endpoint ◽  
Renal Cell ◽  
Clear Cell ◽  
Phase Ii Trial ◽  
Cell Cancer ◽  
Objective Response ◽  
Histologic Subtype ◽  
Limited Effectiveness

411 Background: VEGF- and mTOR-directed therapies achieve inferior outcomes in patients (pts) with advanced non-clear cell renal cell cancer (ncRCC) as compared to clear cell RCC. Limited effectiveness of monotherapy supports the study of combination regimens, and a phase II trial of everolimus (E) + bevacizumab (B) was conducted in pts with metastatic ncRCC. Methods: Treatment-naïve pts received E + B at standard doses until progression or intolerance to therapy. The primary endpoint was progression free survival (PFS) with the goal to see 22 of 34 pts progression-free on treatment >6 months (mo). Correlative analyses include next generation sequencing (NGS) from tumor and germline across 341 genes of interest, as well as immunohistochemistry (IHC) for markers of mTOR activation and vessel density. Results: 34 pts were enrolled, all are evaluable (median follow up 11.2 mo). The most common histologic subtype was unclassified RCC (URCC, n=23), the majority of which had papillary growth as a major component (URCC with papillary features, n=14). Other variants included chromophobe (n=5), papillary (n=4), and medullary RCC (n=2). 19 pts achieved PFS >6 mo; 8 continue on treatment. PFS varied by histology (p<0.001), and objective response rates (ORR) were higher in pts with significant papillary (7 of 18) or chromophobe (2 of 5) elements, than for the remaining pts (1 of 11). Presence of a major papillary component was associated with treatment benefit across the entire cohort (Table), particularly in the subgroup of URCC, where this feature correlated with ORR (43 vs. 11%), median PFS (12.9 vs. 1.9mo) and OS (18.5 vs. 9.3 mo) (p<0.001). IHC markers did not correlate with treatment effect. NGS was performed on 33 cases. Conclusions: ncRCC represent a heterogeneous group of malignancies. This study did not reach its primary endpoint, yet it suggests efficacy for E+B in patients with ncRCC characterized by papillary features. Genomic tumor and germline analysis is being performed to help define the underlying biology. Clinical trial information: NCT01399918. [Table: see text]

C07 Polymorphisms of RAGE and glyoxalase I genes in patients with clear cell renal cell cancer

2013 ◽  
Vol 12 (4) ◽  
pp. e1115, C07
Author(s):  
M. Chocholatý ◽  
K. Havlová ◽  
M. Schmidt ◽  
M. Kalousová ◽  
M. Jáchymová ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Glyoxalase I

NAXIVA: A phase II neoadjuvant study of axitinib for reducing extent of venous tumor thrombus in clear cell renal cell cancer (RCC) with venous invasion.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 275-275
Author(s):  
Grant D. Stewart ◽  
Sarah J. Welsh ◽  
Stephan Ursprung ◽  
Ferdia Gallagher ◽  
Iosif Mendichovszky ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Surgical Approach ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Response Rate ◽  
Clear Cell ◽  
Cell Cancer ◽  
Surgical Morbidity ◽  
Venous Tumor Thrombus ◽  
Extent Of Surgery

275 Background: Venous tumor thrombus (VTT) extension occurs in 4-15% cases of renal cell cancer (RCC). The Mayo classification distinguishes 4 levels of VTT extension between the renal vein and supradiaphragmatic inferior vena cava (IVC). Although surgery is performed with curative intent, mortality is high (5-15%) with complications increasing with the level of the VTT. 5-year survival rates are poor; ~40-65% in non-metastatic RCC. It is hypothesised that neoadjuvant targeted therapy could downstage the VTT reducing the extent of surgery, leading to reduced surgical morbidity and mortality, and increased survival. However, level I or II evidence is lacking. NAXIVA provides the first level II evidence in this patient group, assessing the response of VTT to axitinib. Extensive translational sampling will provide in depth interrogation of VTT (using genomics, proteomics, immunophenotyping and metabolomics) to examine the role of the tumor microenvironment of VTT and response to axitinib. Methods: NAXIVA was a single arm, single agent, multi-center phase 2 feasibility study of axitinib in patients with both metastatic and non-metastatic clear cell RCC prior to nephrectomy and thrombectomy. A Simon two stage minimax design was adopted and the trial designed for adequate power to distinguish a <5% from a >25% improvement in the Mayo VTT level. 21 patients were recruited over a 24 month period between 15/Dec/2017 and 06/Jan/2020 at 5 sites across the UK. Patients were treated with 8 weeks of axitinib (starting dose 5mg bd, increasing to 10mg bd as tolerated) prior to planned surgery. The primary endpoint was the percentage of evaluable patients with an improvement in VTT according to the Mayo classification (assessed using MRI abdomen scans at screening and week 9, prior to surgery. Secondary endpoints were percentage change in surgical approach, percentage change in VTT height, response rate (by RECIST) and evaluation of surgical morbidity assessed by Clavien-Dindo classification. Results: The percentage of evaluable patients with an improvement in VTT according to the Mayo classification was 26.58% [80% CI: 15.76%, 39.74%] (6 of 21 evaluable patients). 35.29% (6 of 17 patients who progressed to surgery) had a change in surgical approach to a less invasive option. There was a median percentage reduction in VTT height of 21.49% (SD=27.60%). The response rate (by RECIST) in the evaluable population was 61.90% SD, 14.29% PR, 9.52% PD. In terms of surgical morbidity 11.76% (2 of 17 patients who progressed to surgery) experienced a Clavien-Dindo 3 or greater complication (0 CD3, 1 CD4, 1 CD5). Conclusions: NAXIVA provides unique prospective data on the feasibility of neoadjuvant axitinib administration to down stage IVC VTT and reduce the extent of surgery. Work is ongoing to establish predictors of response. Clinical trial information: NCT03494816 .

scholarly journals A Four-Gene Promoter Methylation Marker Panel Consisting of GREM1, NEURL, LAD1, and NEFH Predicts Survival of Clear Cell Renal Cell Cancer Patients

2016 ◽  
Vol 23 (8) ◽  
pp. 2006-2018 ◽  
Author(s):  
Iris J.H. van Vlodrop ◽  
Sophie C. Joosten ◽  
Tim De Meyer ◽  
Kim M. Smits ◽  
Leander Van Neste ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Renal Cell Cancer ◽  
Promoter Methylation ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Gene Promoter ◽  
Marker Panel ◽  
Methylation Marker

scholarly journals Phase Ii Study of Individualized Sunitinib As First-Line Therapy for Metastatic Clear Cell Renal Cell Cancer (Mrcc)

2014 ◽  
Vol 25 ◽  
pp. iv292 ◽  
Author(s):  
G.A. Bjarnason ◽  
B. Naveen ◽  
E. Winquist ◽  
C.K. Kollmannsberger ◽  
C. Canil ◽  
...  
Keyword(s):  
Phase Ii ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Phase Ii Study ◽  
Cell Cancer ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Sequential axitinib (AG-013736) therapy of patients (pts) with metastatic clear cell renal cell cancer (RCC) refractory to sunitinib and sorafenib, cytokines and sorafenib, or sorafenib alone

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 5127-5127 ◽  
Author(s):  
J. P. Dutcher ◽  
G. Wilding ◽  
G. R. Hudes ◽  
W. M. Stadler ◽  
S. Kim ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer

Clinical prognostic factors associated with outcome in patients with metastatic clear-cell renal cell cancer treated with everolimus.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 443-443
Author(s):  
Robert J. Amato ◽  
Amber Flaherty ◽  
Somyata Saxena ◽  
Mika Stepankiw
Keyword(s):  
Prognostic Factors ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Left Kidney ◽  
Cell Cancer ◽  
Progression Free Survival ◽  
Factors Associated ◽  
Kidney Involvement ◽  
Clear Cell Rcc

443 Background: Everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor, has demonstrated efficacy affects tumor growth by blocking growth factor stimulation, arresting cell cycle progression, and inhibiting angiogenesis. mTOR inhibitors and agents with primarily antiangiogenic activity have been shown to have efficacy in renal cell cancer (RCC). This study expanded the original everolimus study of 41 patients with metastatic clear cell renal cell cancer to 66 patients to examine outcome and clinical prognostic factors associated with outcome Methods: Patients had confirmed predominantly clear cell RCC. Everolimus was given at a dose of 10 mg daily orally without interruption (28-day cycle), with dose modifications for toxicity (graded according to National Cancer Institute Common Toxicity Criteria, version 3.0). Patients were evaluated every 2 cycles (8 weeks) using Response Evaluation Criteria in Solid Tumors (RECIST). Results: Of 66 evaluable and treated patients, 73% were male, and 45% were >60. Forty-five percent had right kidney involvement, 49% left kidney involvement, and 6% had dual kidney involvement. Eighty-six percent had prior systemic therapy, and 76% of patients had at least two metastatic sites including lung (72%), liver (26%), bone (48%), lymph nodes (50%), adrenal (21%), and other (39%). Twenty-four (36%) of patients had a progression-free survival (PFS) of ≥12 months, and 40 patients (61%) had an overall survival (OS) ≥12 months. Factors most likely to have an influence on OS benefit was high LDH, alkaline phosphatase, and calcium; low hemoglobin; and prior treatment with tyrokinase inhibitors. Conclusions: Everolimus was found to have clinical benefit in patients with clear cell RCC. Clinical prognostic factors may help determine patients most likely to receive benefit from everolimus. Information regarding curves and correlation between prognostic factors and OS and PFS will be presented.

Analgesic use and risk of renal cell cancer: Results from two prospective cohort studies.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 588-588
Author(s):  
Mark A Preston ◽  
Xuehong Zhang ◽  
Rebecca E Graff ◽  
Alejandro Sanchez ◽  
Steven L Chang ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Significant Positive Association ◽  
Increased Risk ◽  
Analgesic Use

588 Background: The relationship between the widely used analgesics (i.e., aspirin, other nonsteroidal anti-inflammatory drugs (NSAID), and acetaminophen) and risk of total and lethal renal cell cancer remains unclear. Methods: We examined the associations between analgesic use and risk of renal cell cancer overall and by subtypes, in the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). We collected information on aspirin, other non-aspirin NSAIDs, and acetaminophen in 1990 in the NHS and in 1986 in the HPFS, and every 2 years thereafter. We used Cox proportional hazards models, controlling for other known and suspected risk factors, to examine the associations between baseline and duration of use of each analgesic and risk of total renal cell cancer, lethal renal cell cancer (resulted in death due to disease), as well as clear cell renal cell cancer. We pooled results using a random-effects model. Results: During follow-up of 22 years among 77,527 women and 26 years among 45,913 men, we documented 438 cases of renal cell cancer (230 in women and 208 in men), of which 106 were fatal (56 in women and 40 in men) and 300 were clear cell (165 in women and 135 in men). The pooled multivariable relative risks (RRs) for total renal cell cancer were 1.13 (95% CI: 0.91-1.39) for aspirin use, 1.34 (95% CI: 1.03-1.75) for non-aspirin NSAID use, and 1.07 (95% CI: 0.80-1.44) for acetaminophen use. Similar results were observed for lethal renal cell cancer and clear cell renal cell cancer. Importantly, longer duration of non-aspirin NSAID use was associated with an increased risk of renal cell cancer. The pooled (all p-heterogeneity > 0.05) multivariable RRs for total renal cell cancer were 1.23 (95% CI: 0.94-1.62) for non-aspirin NSAID users of 4-10 years and 1.81 (95% CI: 1.21-2.72) for over 10 years. The corresponding RRs were 1.91 (95% CI: 1.04-3.49) and 3.97 (95% CI: 1.46-10.83) for lethal renal cell cancer, and 1.36 (95% CI: 0.99-1.88) and 1.58 (95% CI: 0.94-2.63) for clear cell renal cell cancer. Conclusions: Our findings support a significant positive association between non-aspirin NSAID use and risk of developing renal cell cancer, especially the lethal form.

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